A discussion of cuts to the Medicaid program, and how HCR will affect it if implemented.
Via the New York Times:
It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.
The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.
In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group.
Articles like this one are nothing new over the last two years. And as many of you know, if not for the Recovery Act, the problem would be even worse.
With health care reform, presumably to be passed soon, Medicaid will extend its eligibility to individuals up to 133% above the poverty level. Thankfully, the federal government will ease state budgets somewhat by paying 100% of the expansion for (correct if I'm wrong) the first few years, then something like 90% soon thereafter.
What concerns me, however, is what the article addresses - that being the number of providers dropping Medicaid patients. The Medicaid expansion is all well and good, but what if these new enrollees can't find nearby providers?
I don't pretend to be any sort of expert on Medicaid, especially in comparison to many of the knowledgeable diarists we have here, so I thought I'd end the diary with a few questions:
- How much will the $10-14 billion increase of funding for community health centers help Medicaid enrollees find reliable health care access? Admittedly, CHCs are something I know little about.
- Anyone with an idea of how much increasing rates closer to at least Medicare's reimbursement level would cost?
- Somewhat related to #2, why shouldn't Medicaid be converted into a federal program, say, Medicare Part E? I know reimbursement rates vary by location, but that could still be administered at the federal level. More importantly, while it would obviously add to the deficit, it would certainly be a huge ease on crippled state budgets.
- For those more in tune to the health care debate than myself, how soon could we expect an increase in payment rates? Further, what would it likely cost?